Smoking & Diabetes

Diabetics who smoke – leading a life of higher risk

Diabetes is a serious chronic illness that needs to be carefully controlled throughout one’s lifetime. With diabetes, the body does not produce enough insulin, a hormone that helps to process glucose from foods. The sugar stays in the bloodstream and can lead to certain complications affecting the eyes, kidneys, nerves, and heart. Management of diabetes involves regular checking of blood sugar, controlling diet and weight, and consulting the physician regularly for the appropriate screening tests.

It is well known and understood that management of diabetes is a difficult task, but the difficulties are greater if a diabetic patient is also a smoker.

Smoking - The obvious risk factor

Tobacco contains nicotine the substance that makes one physically and psychologically addictive to it. The fact that smoking causes cancer and damage to one’s blood vessels is well known, but the combination of smoking and diabetes increases the risk manifold and brings about even more damage to one’s health. It further increases the risk of life-threatening complications.

There is enough evidence to suggest that smoking is an independent risk factor for diabetes; further, it has also been observed that among people with diabetes, smoking aggravates the risk of serious disease and premature death.

Studies have even shown that, there is a moderate association between smoking and the subsequent development of diabetes.

Further, a prospective study of Japanese men have concluded that age of smoking initiation and number of cigarettes smoked were major risk factors for developing diabetes.

This apart, data from the US Cancer Prevention Study has found that as smoking increased, the rate of diabetes also increased in both men and women.

People with diabetes already have an increased risk of heart disease, which is further elevated if they smoke.

Insulin Resistance in smokers

Apart from the other ills of tobacco, it has also been identified as a risk factor for insulin resistance, a condition which can lead to diabetes. Persons with insulin resistance cannot use insulin properly and such people may initially have higher than normal amounts of insulin circulating in their blood, a condition known as hyperinsulinemia.

Although factors like genetics and obesity, increase a person’s risk of insulin resistance smoking has also been shown to increase the risk of this condition.

According to some studies the culprit behind this is catecholamines, a type of hormone, that are produced in greater quantity in smokers. This particular harmone is known to act in an opposite manner to insulin action. A study involving Type 2 diabetes found insulin resistance was significantly increased among those who smoked.

Smoking and diabetes, together may result in premature death

Sine long, scientists all over the world have agreed that smoking is a risk factor for heart disease. Further, studies also reveal that the elevated risk of heart disease among people with diabetes increases the risk of premature death.

Using logic from these two observations we may say that diabetic person who smoke are at a higher risk of premature death. Setting aside logic, actual studies also confirm that increased smoking elevates heart disease. Further studies have also suggested that smoking may trigger fatal events in people with diabetes whose circulation has been compromised due to vascular disease, or blood vessels damaged by a combination of smoking and diabetes.

Do not complicate your diabetes by smoking

Smoking is associated with multiple complications of diabetes. Diabetic nephropathy (kidney disease) has been shown to be common in Type 1 diabetic patients who smoke. smoking also increases the risk of albuminuria (the presence of protein in urine, which may in turn lead to kidney disease) in both types of diabetes.

Some studies have also found an association between smoking and diabetic retinopathy (damage to the eye nerves)

How you could benefit if you could stop smoking

The good news for diabetics who smoke, is that even if you stop right now, it will do you some good. Recently there has been overwhelming evidence that stopping smoking reduces the risk of cardiovascular disease, lung disease, cancer and stroke.

As diabetes increases the risk for heart disease and stroke, it follows that stopping smoking will reduce the risk of complications from diabetes such as heart disease. Few studies have evaluated smoking cessation treatment specifically for people with diabetes but the limited research available suggests that smokers with diabetes may be less successful in quitting than smokers without diabetes and that intensive strategies should be considered to optimize successful cessation.

One possible explanation for the lower rates of quitting among people with diabetes that stopping smoking is associated with weight gain and this is likely to be of concern in people who have diabetes and are already overweight.

Whatever the reasons for lower rates of quitting may be, smoking cessation advice needs to be a routine component of diabetic care. Although giving advice is easier than following it, diabetics can be given some tips for quitting that may, after all help them in the long run.

Tips for cessation of smoking:

• Deciding to quit, as it is this decision that might win half the battle.
• Not every person finds it easy to quit all at once, much the less, diabetics. Therefore many diabetics may need a well thought out plan.
• In some cases, replacements, for ex. A chewing gum or some other edible thing a diabetic is permitted might be helpful when the urge to smoke is overwhelming.
• In some persons the need to smoke is more situational or confined to a particular place. Identifying these and avoiding such places or situations might help.
• One can always seek the support of family and friends.
• Exercising.
• Deep breathing techniques and meditation can help to reduce stress that is generated when a person does not smoke and it also induces a feeling of well-being.